Setbacks and Injuries

I saw an orthopedic surgeon this morning. I have had chronic left shoulder pain for about 10 years. I’ve seen two other orthopedic surgeons in times past, gotten MRI’s, and tried courses of physical therapy several times, as well as a cortisone injection – none of which produced any significant or lasting relief to the problem.

Shoulder pain has become my norm. I just accepted it as a part of life. To manage it, I get deep tissue massages biweekly, and I ice my shoulder and/or take Aleve if it gets really bad. My shoulder hurts at night, which makes it difficult for me to fall asleep sometimes. I’ve modified my workouts to mostly avoid any movements that aggravate my shoulder pain, although sometimes I am stubborn and push through despite it. Despite my long-standing left shoulder issues, my strength is good in both shoulders and continues to improve.

However, my shoulder pain has become noticeably worse since starting Crossfit. Crossfit places a lot of emphasis on overhead pressing movements (jerks, push press, thrusters, handstand push-ups) and the increased frequency of performing these exercises plus the addition of new movements like the Olympic lifts (snatches, cleans) has aggravated what was a pre-existing problem. I am in no way saying that Crossfit injured me or is unsafe. It revealed a weakness/issue that I have mostly avoided dealing with for a long time.

The good news is that there is nothing severely wrong with my shoulder. The surgeon said I have posterior shoulder contracture (also called frozen shoulder), which means I have limited range of motion in my left shoulder and inflammation in the joint capsule and surrounding tendons. He prescribed me an NSAID, referred me for 4-6 weeks of physical therapy…and told me no pressing movements for the next 4-6 weeks.

I was pretty dismayed by that last part. Removing all pressing movements pretty much means I won’t be able to do most standard Crossfit WOD’s. I’ve worked really hard over the past year to put some size on my shoulders and to increase my strength. Not training them for a month and a half is…unfathomable.

I’m going to admit that my initial reaction was, “F*** this, there is no way I’m taking 6 weeks off from training/Crossfit and going to back to physical therapy yet AGAIN even though it has never been effective in the past!” I was scared. Scared of losing strength and mass. Scared that it wouldn’t work. Scared that I might decide to throw myself a pity party, blow off training and eating healthy all together, and derail completely. Scared of going back to Crossfit after 6 weeks off and feeling like I am starting back at square one.

Honestly, I also doubted the surgeon’s diagnosis. I mean, I’ve been dealing with this shoulder pain for 10 years – the problem has to be something more serious, right? Could he really know what the problem was from a few x-rays, an exam, and talking with me for 5 minutes?

Apparently, he could. I finally decided to research frozen shoulder, and everything fits (from SOSMed website):

Pain at rest and night pain accompany pain with active use.Check!

Progressively worsening pain without preceding injury.Check!

Patients often think they have bursitis or a rotator cuff tear because the shoulder hurts with active use. Check!

Strength is generally unaffected but limited by pain. Check!

Night pain and pain that awakens patients from sleep is one of the most troublesome symptoms.Check!

Some patients have pain that radiates into the neck, back or upper arm due to shoulder fatigue. Check!

You know what finally won me over though?

NOTE: Many patients will have engaged in previous program of physical therapy but may have failed to improve. Often, the programs have focused on muscle strengthening exercises for a presumed diagnosis of rotator cuff tendonitis or impingement syndrome. Little emphasis will have been placed on a thorough and comprehensive flexibility program, and muscle strengthening may actually increase shoulder pain in the early phases of the process. Our repeated observation is that may patients who have failed previous physical therapy will benefit from further treatment once the appropriate diagnosis has been established and the exercises focused on stretching rather than strengthening.

There went my last argument. My previously unsuccessful attempts at physical therapy debunked.

Sadly, this means I can’t participate in Crossfit for Hope next weekend since power snatches and thrusters are part of the WOD. I am pretty bummed about the short-term restrictions I have to follow, but am trying to keep the big picture perspective and consider the long-term benefits of following the physician’s orders.

In my sport psychology classes, injuries were always a topic of interest. Many an athlete has been derailed by an injury, but being injured or limited in training doesn’t mean you are helpless. While I may not be able to do much upper body training, I can use the next several weeks to really focus on training my lower body and working on a weak point of mine in Crossfit, which is running. In fact, when I ran the half marathon a few years ago, it was because I had to take a break from weightlifting due to shoulder pain for a few months. In addition, I am hopefully setting myself up for long-term progress in training and Crossfit by addressing my shoulder problem now before it turns into something more serious. I hope that the future Me will be grateful that I took this time out to recover.

Despite my initial reaction, this is not catastrophic. This is a speed bump, not a dead-end. Pity party over – heading to the gym tonight to hit legs heavy!